Permit CITY OF TIGARD MASTER PERMIT
COMMUNITY DEVELOPMENT Permit#: MST2023-00075
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2023
Parcel: 2S103BB09001
Jurisdiction: Tigard
Site address: 12245 SW WALNUT ST
Subdivision: LAKE TERRACE Lot: 17
Project: Hasson
Project Description: New exterior emergency exit staircase.
BUILDING
Floor Areas Required Setbacks Required
Stories: Bedrooms: First: sf Basement: sf Left: Parking Spaces:
Height: Bathrooms: Second: sf Garage: sf Front: Smoke
Dwelling Units: Third: sf Right: Detectors:
Total: sf Value: $3,500.00 Rear:
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Urinals:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Drains: Storm Sewer:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Catch Basins:
Footing Drain: Ice Maker: Hose Bib: Backwater Value:
Bckflw Prevntr:
Drywell-Trench Drain: Other Fixtures:
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers:
Heat Pump: N Hoods: Other Units:
Furn<100K: Vents: Woodstoves: Gas Outlets:
Furn>=100K:
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0-200 amp: 0-200 amp: W/Svc or Fdr:
Ea add'500 sf: 201-400 amp: 201-400 amp: W/O Svc/Fdr:
Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp:
601-1000 amp: 601+amp-1000v:
1000+amp/volt:
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
N
Other: N Other Description: Ecompasing:
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R-3
Owner: Contractor:
PARKER,JAMES C OWNER Required Items and Reports(Conditions)
HASSON,JENNIE L
12245 SW WALNUT ST
TIGARD,OR 97223
PHONE: PHONE:
FAX:
Total Fees: $244.13
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work
will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more
the 180 days. ATTENTION: Oregon law requir you to folio the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
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Issued By: Permittee Signature: . 57/(L ee/41 L
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
Building Permit Review - Residential
TIGARD
Building Permit #: inSi,903-
Site Address: IZZM 3 3 W40Vi U C9'Verified in Accela
Project Name: SOV\ Q,'e...V l Lot/Unit #:Proposal (include housing type): i\ ii ey-t 'l di' S`}Z\1\Y74 S nn�one: - s
Required Site Plan Elements:
❑ 3 copies of site plan on max 11x17"
❑ Drawn to standard scale 0 Retained trees, drip line/ tree protection
❑ North arrow 0 Street and site trees shown / labeled
❑ Site address, project name, lot # 0 Table calculating tree canopy at maturity
❑ Street names (N/A for SFR)
❑ Applicant name and phone # 0 Courtyard rectangle dimensioned (if applicable)
O Lot and setback dimensions 0 Vision clearance triangle
O Existing structures & square footage 0 Utility locations &easements
❑ Footprint of new structure and FFE 0 Property corner elevations
❑ Sidewalk/driveway dimensioned 0 LIDA (>1,000 sf disturbance)
❑ Lot area and lot coverage percentage 0 Erosion control
Required Elevation Plan Elements:
(For SFR: calcs needed only on street-facing) Garage doors dimensioned
❑ Drawn to standard scale Summary table with calculations for:
O Building height dimensioned 0 Total façade area
❑ Façade dimensioned 0 Total window and door area
❑ Windows and doors dimensioned 0 Total garage area
Required Floor Plan Elements: ❑ Summary table that includes
O Each story dimensioned 0 Total floor area
O Each story floor area calculated 0 Floor area per story
Planning Review
The following standards have been met:
fl a
Setbacks Front: I5 Rear: I() Side: Min/Max Street Side: iJ 4( Garage: Ni f
Height 11]41ax. Height: 30 Proposed Height:
O Yes Landscape
O Yes Screening (Quad only)
O Yes nI.NItA % Window Coverage
O Yes S N/A Garage (SFR Only)
,- Parking (Other Res)
❑ Yes C-I"VA Entrance (SFR, Rowhouse, Quad only)
❑ Yes E '' A Other building design standards (Rowhouse only)
❑ Yes N/A Accessory Structure Standards
existing unit exempt from standards (Cottage unit only)
Additional standards for Courtyard Units, Cottage Clusters, Rowhouses, and Quads:
O Yes 0 N/A Unit Count:
❑ l�es N/A Lot Width and Size
❑ Yes ❑ N/A Pathway
Additional standarfo"r`"Courtyard Units and Cottage Clusters only:
❑ Yes 0 N/A -k iTt Area:
❑ Yes Floor Area (per story)
es 0 N/A Courtyard
O Yes 0 N/A Fence
❑ Yes ❑ No Mig/A Clean Water Services - Service Provider Letter (lot platted prior to 9/10/1995)
❑ Yes 0 No lieriA.Public Facilities Improvement (PFI) Permit:
Required: ❑ Yes i -N-o
Applied For: 0 Yes 0 Now stop intake
❑ Sensitive Lands: 0 Yes IfiVo
O Land Use Case #: 0 Conditions met prior permit issuance
Approved By, Tanning: . 1 t v 1." Z I Date: 1 I I ZS
Notes .Mid C 2Q2- - oG c i
Revision 1: 0 Approved 0 Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
Building Permit Submittal
Original Submittal Date: 3/7/2 3
Site Plans #: 3
Building Plans #: 3
Building Permit #: ild. g permit entered on page 1
Workflow Routing: awning ngineering ermit Coordinator i ding
Workflow Sign-off: 4 Sig off for Planning (include notes from planning review)
Route Documents: ci- gineering: (1) copy of permit application, (1) site plan,(1) building plan
and original plan review routing form.
ding: original permit application, site plans, building plans, engineer and
beam calculations and trust details, if applicable, etc.
Permit Technician: / Date: ,3/7/23
Notes:
Engineering Review
IE FI Permit: h!'v
Er5lope at building pad: /c
0,0
mermit ,I''
Cat' asements ditions (encroachmentetpriorto s) perissuance of engineeringp conditions of approval and plat �c.'
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: 0 Yes iio
Assess Water Quantity Fee in-lieu: 0 Yes 1=4/-No
LIDA Facility on lot: 0 Yes l 'No Add Fee: ❑ Yes 0 No
❑ Final Plat Recorded
❑ NOT Approved: Date:
Notes: /
Approved By Engineering: ,7`t ign?���-7 Date: -3/�` zUL 3
Revision 1: ❑ Approved 0 Not Approved Date:
Revision 2: ❑ Approved 0 Not Approved Date:
Permit Coordinator Review
Nf.Conditions met prior to permit issuance
❑ Approved, NOT Released: Date notified applicant:
❑ ENG Revisions Required:. Date notified applicant:
;SDC Exemption: ❑ Applied for ❑ Received Does not apply
A SDC Fees Entered: Wash Co Trans Dev Tax: 0 Yes /N/A
Tigard Trans SDC: ❑ Yes /N/A 0 Deferred
Parks SDC: ❑ Yes /N/A ❑ Deferred
LIDA ❑ Yes /N/A
OK to Issue/Approved by Permit Coordinator: Date: altg ITO 2-'.
Revision 1: ❑ Approved ❑ Not Approved
Date:
Revision 2: 0 Approved 0 Not Approved Date:
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325(2))
This statement is required for residential building,electrical,mechanical,and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010(7),need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
1 I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If 1 hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
Jitik(e.,
Print Name of Pe 'it Applica
) / ,
Signature of Per F• t / Date
110
Permit#: ,,
Address: •
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y�C
Issued by: Date: t r
This Copy for Permit Offices
Information Notice to Owners About
1k . h` Construction Responsibilities
�r.l`i (ORS 701.325 (3))
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure,can prevent many problems
by being aware of the following responsibilities:
• Homeowners who use labor provided by workers not licensed by the Construction Contractors
Board, may be considered an employer, and the workers who provide the labor may be considered
employees. As an employer,you must comply with the following:
• Oregon's Withholding Tax Law: Employers must withhold income taxes from employee wages
at the time employees are paid. You will be liable for the tax payments even if you don't actually
withhold the tax from your employees. For more information, call the Department of Revenue at
503-378-4988.
• Unemployment Insurance Tax: Employers are required to pay a tax for unemployment insurance
purposes on the wages of all employees. For more information, call the Oregon Employment
Department at 503-947-1488.
• Oregon's Business identification Number(BIN): is a combined number for both Oregon
Withholding and Unemployment Insurance Tax.To file for a BIN, call 503-945-8091 or go to
htto://www.oregon.gov/DOR/BUS/docs/2111-055.odf for the appropriate forms.
• Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation insurance for their employees. If you fail to obtain
Workers Compensation Insurance, you could be subject to penalties and be liable for all claim costs
if one of your workers is injured on the job. For more information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 503-947-7815.
• Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages.You may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their website at www.irs.gov.
Other Responsibilities of Homeowners:
• Code Compliance:As the permit holder for a construction project, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
• Property Damage and Liability Insurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray,water damage from pipe punctures,fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the Job site who are not
otherwise covered as employees by Workers Compensation insurance.
• Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough-in and finish trades.
CONSTRUCTION CONTRACTORS BOARD
PO Box 14140, Salem,OR 97309-5052
Telephone:503-378-4621—Fax:503-373-2007
Website Address:www.oregon.aov/ccb
f/property_owner adopted 9-23-08 This Copy for Permit Applicant